Hi Dr. Frascino, I enjoy reading your forums, you are an outstanding voice in the HIV community and your list of achievements blows me away.
I'm 27 years old, did not have my first sex with another guy until I was probably 22. Tomorrow I'm going for my first HIV test, I know that it's long, long overdue. I guess it's going to be a "rapid test", the lady at the clinic said I go in, blood is taken, and I wait about 45 minutes for the results. How accurate are these tests? I have several questions for you, regarding risk of HIV transmission. I'm curious as to what the term "per act" means, such as the risk of contracting HIV through insertive anal sex is "6.5 per 10,000 episodes". I'm horribly ashamed to say that out of all the times I've had anal sex (every time has been with me as the top) that around half of the occurances have been without a condom. How bad do you think it looks for me? I've barely been able to eat or sleep for about the last 2 weeks. My disgust with myself over being so careless and idiotic is immeasurable. If I test positive tomorrow I seriously don't know what i'm going to do with myself. The idea that I may have unknowingly hurt someone else is causing me to have suicidal thoughts. Thank you so much for any words you have for me, and God bless you.

Response from Dr. Frascino

Hi,

1. How accurate are rapid tests? Extremely! Just check the archives for additional details.

2. "Per act" means the statistical risk for that particular type of exposure is exactly the same for each separate sexual episode you have. Like flipping a coin. The chances of it landing on heads (or tails) are 50% (or 1 in 2) each and every time you flip the quarter.

3. How bad does it look for you? Well, there is no doubt unprotected anal sex is risky and an HIV test three months or greater from your last potential episode is warranted. Despite this, the odds are still very much in your favor. I'm glad you are going to get tested and have realized the potential consequences of your actions. I feel confident you will no longer place yourself at risk. I'll send my good-luck karma that your definitive HIV test is negative.

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